RELEVANT ETHICO-LEGAL

GUIDELINES IN CONDUCTING
HEALTH ASSESSMENT

WEEK 14 AND 15
 INFORMED CONSENT
• An agreement by a client to accept a course of treatment or a procedure
after being provided complete information by a health care provider
Purpose: to have a mutual decision-making between the professional and the
patient when it comes to the treatment options that the patient would want/not
want
• Need to have a record of the consent
• Patient can sign the consent as long as the patient is able, capable, with
sound mind, competent enough to understand, and of legal age
• It will be the next kin or legal guardian who will sign the consent for minors
(informed permission)
• Minors who can sign the informed consent are called emancipated minors
Emancipated Minor
• Married minors
• Serving in the military
• Financially independent
• Mothers

EXCEPTIONS IN INFORMED CONSENT

1. Patient is incapacitated
2. Life-threatening emergencies with inadequate time to obtain consent
3. Voluntary waived consent
TYPES OF INFORMED CONSENT

1. Express
➢ Needs to be expressed
➢ Orally or written
2. Implied
➢ Non-verbal cues that indicate agreement
 MAJOR ELEMENTS
1. Must be given voluntarily (no coercion)

2. Must be given by an individual with the capacity and competence

to understand (unless it is a life-threatening situation)

3. Individual must be given enough

• information to be the ultimate decision-maker
Cultural Considerations:
In some cultures like in the US, they value the principle of autonomy
Southeast Asian countries- we would rely on group discussions before we can
arrive at decisions . In any case, you must ask the patient or next kin if there is
a specific relative that they want to be present there while explaining.
PATIENT BILL OF RIGHTS
1. Right to Appropriate Medical Care and Humane Treatment.
• Every person has a right to health and medical care
• Patient has the right to appropriate health and medical care of good quality
• Patient’s human dignity, convictions, integrity, individual needs and culture shall be
respected
• Patient has the right to be directed to wait for care, or be referred or sent for treatment
elsewhere, where the appropriate care can be provided
• Patients in emergency shall be extended immediate medical care and treatment without any
deposit, pledge, mortgage or any form of advance payment for treatment
2. Right to Informed Consent.
The patient has a right to a clear, truthful and substantial explanation, in a
manner and language understandable fpr the patient, of all proposed procedures,
whether diagnostic, preventive, curative, rehabilitative or therapeutic
That the patient will not be subjected to any procedure without his written
informed consent, except in the following cases:
• Emergency cases
• Epidemic control
• Law makes it compulsory for everyone to submit a procedure
• Patient is a minor, legally incompetent and requires a third-party consent
• Disclosure of material information to patient will jeopardize the success of treatment
• Patient waives his right in writing
 CONT. RIGHT TO INFORMED
CONSENT
Informed consent is obtained from a patient concerned if he is of legal age and of
sound mind, the following persons may give consent:
• Spouse
• Son or daughter of legal age
• Either parent
• Brother or sister of legal age
• Guardian
3. Right to Privacy and Confidentiality.
The patient has the right to be free from unwarranted public exposure, except
in the following cases:
• When his mental or physical condition is in controversy and the appropriate
court, in its discretion, order him to submit to a physical or mental
examination by a physician
• When the public health and safety so demand
• When the patient waives this right in writing
 CONT. RIGHT TO PRIVACY…
The patient has the right to demand that all information, communication and
records pertaining to his care be treated as confidential, except:
• When such disclosure will benefit public health and safety
• When it is in the interest of justice and upon the order of a competent court
• When the patients waive in writing the confidential nature of such
information
• When it is needed for continued medical treatment or advancement of
medical science
4. RIGHT TO INFORMATION
• The patient or his/her legal guardian has a right to be informed of the result of the
evaluation of the nature and extent of his/her disease •
• The patient or his legal guardian has the right to examine and be given an itemized
bill of the hospital and medical services rendered in the facility or by his/her
physician and other health care providers o The patient is entitled to a thorough
explanation of such bill
• The patient or his/her legal guardian has the right to be informed by the physician or
his/her delegate of his/her continuing health care requirements following discharge
• The patient is entitled to a brief, written summary of the course of his/her illness •
He/she is likewise entitled to the explanation of, and to view, the contents of medical
record of his/her confinement but with the presence of his/her attending physician or
in the absence of the attending physician, the hospital's representative
5. RIGHT TO CHOOSE HEALTH CARE
PROVIDER AND FACILITY
• The patient is free to choose the health care provider to serve him as well as
the facility except when he is under the care of a service facility or when
public health and safety so demands or when the patient expressly waives
this right in writing
• The patient has the right to discuss his condition with a consultant specialist,
at the patient’s request and expense

• The patient has the right to seek for a second opinion and subsequent
opinions, if appropriate, from another health care provider/practitioner
 6. RIGHT TO SELF-DETERMINATION
The patient has the right to avail himself/herself of any recommended diagnostic and
treatment procedures
• Any person of legal age and of sound mind may make an advance written directive
for physicians to administer terminal care when he/she suffers from the terminal
phase of a terminal illness, provided that:
• He is informed of the medical consequences of his choice
• He releases those involved in his care from any obligation relative to the
consequences of his decision
• His decision will not prejudice public health and safety
7. Right to Religious Belief.
• The patient has the right to refuse medical treatment or procedures which may be
contrary to his religious beliefs

8. Right to Medical Records.

• The patient is entitled to a summary of his medical history and condition he has the
right to view the contents of his medical records, except psychiatric notes and other
incriminatory information obtained about third parties
• At his expense and upon discharge of the patient, he may obtain from the health
care institution a reproduction of the same record whether or not he has fully settled
his financial obligation with the physician or institution concerned
• The health care institution shall safeguard the confidentiality of the medical records
and to likewise ensure the integrity and authenticity of the medical records
 9. RIGHT TO LEAVE
• The patient has the right to leave hospital or any other health care institution regardless of
his physical condition, provided that:
• He/she is informed of the medical consequences of his/her decision o He/she releases those
involved in his/her care from any obligation relative to the consequences of his decision
• His/her decision will not prejudice public health and safety
• No patient shall be detained against his/her will in any health care institution on the sole
basis of his failure to fully settle his financial obligations, However, he/she shall only be
allowed to leave the hospital provided appropriate arrangements have been made to settle the
unpaid bills
10. Right to Refuse Participation in Medical Research.
• The patient has the right to be advised if the health care provider
plans to involve him in medical research, including but not limited to
human experimentation which may be performed only with the
written informed consent of the patient
11. Right to Correspondence and to Receive Visitors.
• The patient has the right to communicate with relatives and other
persons and to receive visitors subject to reasonable limits
prescribed by the rules and regulations of the health care institution
12. Right to Express Grievances.
• The patient has the right to express complaints and grievances about the
care and services received without fear of discrimination or reprisal and to
know about the disposition of such complaints

13. Right to be Informed of His Rights and Obligations as a Patient.

• Every person has the right to be informed of his rights and obligations as a
patient
“It shall be the duty of health care institutions to inform of their rights as well as
of the institution's rules and regulations that apply to the conduct of the patient
while in the care of such institution.”
 DATA PRIVACY ACT
• Republic Act No. 10173, also known as the Data Privacy Act of 2012
(DPA), aims to protect personal data in information and communications
systems both in the government and the private sector.
• Protect the fundamental human right of privacy, of communication while
ensuring the free flow of information to promote innovation and growth.
• It ensures that entities or organizations processing personal data establish
policies, and implement measures and procedures that guarantee the safety
and security of personal data under their control or custody, thereby upholding
an individual’s data privacy rights.
• With regard to health care, everyone knows that all personal health
information is confidential and with the growing digital economy, stricter privacy
and security protections of health data must be implemented.
• Breach is a security incident that leads to unlawful or
unauthorized processing of personal, sensitive or privileged
information…
• Consent of the data subject refers to any freely given, specific,
informed indication of will, whereby the data subject agrees to the
collection and processing of his or her personal, sensitive or
privileged information.
• Evidenced by written, electronic or recorded means o Given on
behalf of a data subject by a lawful representative or an agent
specifically authorized by the data subject to do so
• Data subject refers to individuals whose personal, sensitive, or privileged
information is processed.
• Information and Communications System refers to a system for
generating, sending, receiving, storing or otherwise processing electronic
data messages or electronic documents.
• Personal data refers to personal information, sensitive information or
privileged information.
• Personal information refers to any information whether recorded in a
material form or not.
• Privileged information refers to any and all forms of data which under the
Rules of Court and other pertinent laws constitute privileged communication.
 THE NATIONAL PRIVACY COMMISSION

The National Privacy Commission is an independent body

mandated to administer and implement the Data Privacy
Act of 2012, and to monitor and ensure compliance of the
country with international standards set for data protection.
FUNCTIONS OF NATIONAL PRIVACY
COMMISSION
• Rule Making
• Advisory
• Public Education
• Compliance and Monitoring
• Complaints and Investigation
• Enforcemets
 DATA PRIVACY PRINCIPLES
• Transparency
Processing of personal data shall be known to the data subject, who must be
informed about the nature, purpose, method, and extent of processing.

• Legitimate purpose
The processing of information shall be compatible with a declared and
specified purpose which must not be contrary to law, morals or public policy.

• Proportionality
The processing of information shall be adequate, relevant, suitable, necessary
and not excessive in relation to a declared and specified purpose
RIGHTS OF DATA SUBJECT
The data subject is entitled to the following rights:

• Right to be informed
• Right to object
• Right to Access
• Right to correct
• Right to Rectification, Erasure or Blocking
• Right to damages
PENALTIES
Unauthorized Processing of Personal Information and Sensitive Personal
Information
• The unauthorized processing of personal information shall be penalized by
imprisonment ranging from one (1) year to three (3) years and a fine of not
less than Five hundred thousand pesos (Php500,000.00) but not more than
Two million pesos (Php2,000,000.00)
• The unauthorized processing of sensitive personal information shall be
penalized by imprisonment ranging from three (3) years to six (6) years and a
fine of not less than Five hundred thousand pesos (Php500,000.00) but not
more than Four million pesos (Php4,000,000.00)